Review of Occupational & Professional Licensing - Executive Order 2021-01
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SPENCER J. COX Governor DEIDRE M. HENDERSON MARGARET W. BUSSE JACOB HART Lieutenant Governor Executive Director Deputy Director June 25, 2021 The Honorable Spencer J. Cox, Governor of Utah The Honorable Deidre M. Henderson, Lieutenant Governor of Utah State Capitol 350 N State St Salt Lake City, Utah 84114-2325 Re: Executive Order 2021-01 Requiring a Review of All Regulated Occupations and Professions Dear Governor Cox and Lt. Governor Henderson: On behalf of the Department of Commerce, I am pleased to submit the following report required by Executive Order 2021-01. As requested, each division within the department evaluated regulations within their purview that impact occupational and professional licensing. While all divisions have some regulatory influence on Utah’s workforce, the Division of Securities, Division of Real Estate, and Division of Occupational and Professional Licensing were found to have direct impact, and are the focus of this report. The Department has strived over the years toward its mission of strengthening trust in Utah’s commercial activities by balancing the free flow of commerce with protecting the health and safety of Utah citizens. Department staff and our various boards and commissions have embraced the concept that while regulation is necessary, it can often create unintended consequences that end up harming those it aims to protect or become outdated as the economy and workforce needs shift. The efforts made with this concept in mind to right-size regulation have elevated Utah as a leader in the nation for licensing reform. However, as we undertook this comprehensive review of our regulations for Executive Order 2021-01, it became apparent that even with the intense focus we have placed on this mission, regulatory creep was still an issue. As this report highlights, there are many areas that can be improved upon. Many of the changes are already underway; however, not all the work needed could be completed in the short six months allotted by the executive order. Many of the areas of concern will require time and analysis to ensure that the proper solution is codified. Additionally, many changes will require legislation. Further, as the Department approached this review, it was evident that even as an agency actively seeking reform opportunities, we could not always prevent unintended consequences from forming within our regulation. This was especially evident in dated regulation that had not kept up with technological and market needs.
It is our firm belief that in addition to being reasonable and reliable at the time they are enacted, regulation must remain relevant in order to best serve the public. Within this report, the various divisions share ideas to update statutes and rules. Further, as a Department, we propose a revision to Utah’s occupational and professional licensing reform structure that will leverage the efforts that all executive branch agencies have put forth over the last several months by standardizing the guiding principle that we should routinely take a fresh look at our regulations to ensure balance. The systematic licensing review process proposal found within this report will continue the hard work that our agency, and so many others, have undertaken at your direction. As stated in the Executive Order, “government should periodically review regulations to ensure they are serving their intended purpose.” It is our hope that resourcing robust and dispassionate licensing analysis will not only reduce frustration with the licensing reform process amongst stakeholders, but will both encourage government to keep pace with the need to evolve with changes in the economy and spur the long-term licensing reform necessary to open up pathways to economic opportunities for Utahns now and in the future. Sincerely, Margaret Woolley Busse Executive Director Department of Commerce State of Utah
Review of Occupational & Professional Licensing in Response to Executive Order 2021-01 Utah Department of Commerce Margaret Woolley Busse – Executive Director Jacob Hart – Deputy Director Mark Steinagel –Director, Division of Occupational and Professional Licensing Jonathan Stewart –Director, Division of Real Estate Jason Sterzer – Director, Division of Securities Report compiled by: Chris Parker – Director, Division of Public Utilities Carolyn Dennis – Management Analyst
REVIEW OF OCCUPATIONAL & PROFESSIONAL LICENSING IN RESPONSE TO EXECUTIVE ORDER 2021-01 Overview .................................................................................................................................... 1 Scope of Review .................................................................................................................... 1 Process .................................................................................................................................. 2 SECTION I ................................................................................................................................. 3 Unnecessary and Amendable Rules ....................................................................................... 3 Division of Occupational and Professional Licensing (DOPL).............................................. 3 Division of Real Estate ........................................................................................................ 4 Division of Securities ........................................................................................................... 5 Removing Barriers .................................................................................................................. 5 Create narrower licenses from broad scope-of-practice licenses ........................................ 6 Competency measures to replace educationally-based requirements when possible ......... 6 Miscellaneous issues identified ........................................................................................... 7 Ongoing Departmental Rule Review ....................................................................................... 8 SECTION II ...............................................................................................................................10 Regular, Systematic Review of Professions ..........................................................................10 Regular, ongoing, impartial review by the executive branch ...............................................10 Ongoing legislative input to executive branch ....................................................................11 Licenses to consider for evaluation utilizing the proposed process ....................................12 SECTION III ..............................................................................................................................14 Required Actions ...................................................................................................................14 Modification to board and division duties ............................................................................14 Statutory changes ..............................................................................................................14 Considerations for Future Licensing Reform ..........................................................................16 APPENDIX................................................................................................................................17 Past regulatory changes ........................................................................................................17 Division of Occupational and Professional Licensing .........................................................17 Division of Real Estate .......................................................................................................29 Division of Securities ..........................................................................................................33
OVERVIEW Optimal systems of commerce enable creative and useful exchanges of goods and services in ways that support human thriving and increase individual and societal wealth. Government is a small but important component of a healthy commercial environment, enabling a system that protects against predation. These protections decrease risk, and thus the ultimate cost, of commercial exchanges. Effective and efficient regulation of conduct that might injure others instills trust that ultimately adds more value than the regulation costs. Nevertheless, the task of government regulation is not best undertaken with a set of constant rules that, once adopted, simply continue in perpetual effectiveness. Rather, as people, skills, technology, and markets change, government must constantly reevaluate rules to ensure they are productive and add value to the commercial system, instead of burdening it. Recognizing that constant evaluation of existing governmental rules and processes is necessary and helpful, Governor Spencer J. Cox and Lt. Governor Deidre M. Henderson signed Executive Order 2021-01, requiring state executive agencies to: review administrative rules and other regulations for occupational or professional licenses within the agency’s scope of authority and identify rules and regulations that are no longer necessary or can be amended to reduce barriers to working while still protecting the health, safety, and well-being of Utah residents.1 Under this direction, the Department of Commerce undertook a rigorous review of its administrative rules, agency practices, and the statutes authorizing those rules and practices. Agency management also held 25 meetings with legislators, industry representatives, and reform groups. Further, the department conducted a stakeholder survey seeking feedback on what was and was not working in Utah licensing and received 80 responses. This report outlines the department’s review process, the actions to which it has led, and numerous recommendations for consideration by other policymakers. Scope of Review In response to Executive Order 2020-01, department management immediately began to establish the scope of our review, which included a complete review of all statutes and rules involving occupational and professional licensing within the department. While the Division of Occupational and Professional Licensing (DOPL) is the largest and most obvious participant in occupational and professional licensure within the department, each division was evaluated for inclusion in the review. The Division of Real Estate (DRE) and the Division of Securities (SEC) also license professionals and were included in this review. Although other divisions’ work falls outside the scope of Executive Order 2020-01, the exercise of considering whether they were included caused each division agency to give additional thought to how that agency’s rules might affect work in the state. Some small rule changes to optimize rule provisions in those divisions agencies are likely to follow, despite not being included in this report. 1 https://rules.utah.gov/wp-content/uploads/Utah-Executive-Order-No.-2021-01.pdf 1 Page
Process The department regulates numerous professions, each with its own statutory authorization and many with their own specific sets of administrative rules. A department employee or board member, and in many cases both, reviewed each rule to evaluate its fit under Executive Order 2020-01. In doing so, reviewers considered not merely the larger rule’s necessity, but each element’s utility in meeting the statutory mandate underlying the rule. Reviewers considered a number of factors in evaluating a rule’s necessity or advisability. Executive Order 2020-01 required consideration of whether a rule is necessary or artfully targeted to protect Utahns’ health, safety, or welfare. The department’s rules are largely compulsory under federal or state statutes. Reviewers considered whether each element of each rule was required by state or federal statute, whether a less restrictive way of satisfying the statute existed, or whether the rule was discretionary. Where the rule and all of its elements are required by law, the respective division has considered whether to make recommendations for statutory changes in Section II of this report. For discretionary rules, department leadership and each division considered the following questions: Why was the rule established? Can the rule be repealed without the risk of significant, present, recognizable harm to the public? If not, why not? If a rule is necessary to protect against significant, present, recognizable harm to the public, what is the narrowest way to provide that protection? Can portions of the rule be eliminated? Does the rule’s burden outweigh its benefit to the public? (Consideration of burdens should include burdens to those seeking licensing, preserving current licensure, and the rule’s general economic effect, including decreasing the supply of the particular service.) Can the harm against which the rule protects be mitigated in a less burdensome way than administrative rule? For rules addressing process, not harm, can processes be made more user-friendly or efficient? The results of these reviews are reported in Section I of this report, with general discussion of the findings followed by specific action already undertaken or to be undertaken. Section II includes a variety of recommendations, encompassing a regular statewide process for systematic reviews of individual professions and recommendations for licenses that could be considered for elimination from state code. In Section III, we summarize required actions and provide considerations for future reforms. An appendix highlights the department’s previous and ongoing actions to improve and reform licensure within its ambit. 2 Page
SECTION I Our review of existing regulation identified a number of rules that will benefit from immediate amendment, some rules that require statutory changes or additional study to reduce barriers and achieve beneficial changes while preserving necessary protections, and the need for an ongoing internal rules review process. These findings and actions are described below. Unnecessary and Amendable Rules While an executive branch agency has little control over the existence or form of the statutes it is charged with enforcing, it is accountable for the rules it is both mandated and empowered to adopt in furtherance of those statutes. Accordingly, the department’s agencies have reviewed its rules in light of Executive Order 2020-01. Listed below are rules the agency has identified for changes based on the order. They are separated by division for ease of reference. Some of the rule changes have been or will be undertaken by the respective divisions. Other changes require change to the underlying statutes before the agency can amend the rule. Where legislative change is required, it will be noted below. Division of Occupational and Professional Licensing (DOPL) In recent years DOPL has increased its proactive work to rid its rules of provisions with little nexus to the meaningful regulation of professions. Recognizing the need for this to be an ongoing and routine process, DOPL used the concepts presented within Executive Order 2020-01 as a framework to review each of the over 60 chapters that fall within Title 58, along with the corresponding rules, as part of this review. This intensive process identified a number of rules that should be repealed or amended to better tailor regulation to public need. These are presented below in a table identifying key categories of rules to be revisited. In many cases, the relevant boards have already voted to make changes and the rulemaking process has begun. In other instances, action remains. Among other things, the changes contemplated for the listed rules include broader acceptance of various exams, recognition of past experience or competence (i.e. military experience), and removal of sequence requirements for education and experience. Reason Rule Section Over expansive moral character rule R156-11a-302 R156-20b-302 R156-37-303 R156-47b-302d R156-55d-302f R156-63a-302f R156-63b-302g R156-73-302 Unnecessary or poorly tailored education, R156-22-302f(1)(a) exam, or experience provisions R156-46a-302a R156-41-601 R156-47b-302a R156-54-301 R156-55b-302a/c R156-55c-302a/c R156-61-302c 3 Page
Outdated rules or rules exceeding the least Various continuing education sections2 restrictive standard to match statute R156-20b-302c R156-24b-308 R156-31b-301a/b/c/d R156-64-302c, 304 R156-76-302c(1) In addition to the in-process changes identified above, the division has also identified many items that require time and study, and are ripe for evaluation if not immediate action. Over the next year, the division will work to find the proper solution within these areas. Examples include: Evaluate the inclusion of professions under Emergency Order Exemptions considering the lessons learned over the last year working through both health and natural disaster emergencies. Explore options with various national testing providers to include offering exams in additional languages in accordance with Utah Code Section 58-1-311. Explore ability to offer DOPL practical exams in rural areas. Plans are already proceeding for plumbing and electrical exams. Evaluate method of assisting students preparing for entry to professions by developing testing resources, e.g. lending library for expensive test prep materials. Review education requirements set by administrative rule to ensure they are tightly aligned to the professional practice and harm reduction associated with the need for licensing. Evaluate the efficacy of permitting additional education evaluations for individuals who received initial training outside the United States or from non-approved programs. Review criteria set in administrative rule for dental anesthesia permits against best practices. Evaluate pathways to licensure for nursing applicants who do not complete the required exam within 5 years of graduation. Division of Real Estate The division has identified a number of rules that can benefit from amendment or repeal, identified in the table below. Some of these will require statutory changes. For example, rule R162-2c- 201(1)(a)(i) and R162-2c-202 outline the criteria for satisfying the statutory requirement that mortgage licensees demonstrate good moral character (Utah Code Section 61-2c-203(1)(b)). The expansive requirement to demonstrate good moral character is a traditional requirement for many professional licenses but it suffers from overbreadth and risks unmooring actual requirements from a meaningful nexus with specific professions. While the division will consider whether its rule is more expansive than the statutory requirement, the Legislature should consider whether the statute should be tailored to provide guidance better targeted to the public’s and professions’ needs. Reason Rule Section Over expansive moral character rule R162-2c-201(1)(a)(i) R162-2c-202(1) R162-2g-310(4) Over expansive crime of moral turpitude rule R162-2c-202(1)(a)(i)(C)(I) R162-2g-310(4) Unnecessary Fees R162-2f-105 2All continuing education provisions will be amended to require retention of records for only one two-year renewal cycle, not the four to six years many sections currently require. 4 Page
R162-2g-306b(3)(c) R162-2f-202d Increase authority for technology- enabled R162-2c-203(6)(h)(ii)(A) education Outdated rules or rules exceeding the least R162-2c-301b restrictive standard to match statute R162-2f-402 R162-2f-202b(5)(c) In addition to the existing rules listed above, the division is working on expanding pathways for licensure. Becoming a licensed appraiser is a complex and difficult process that is often restricted by the applicant’s ability to obtain timely experience opportunities. Recently, Practical Applications of Real Estate Appraisal (PAREA) was developed by the Appraisal Foundation, providing a new pathway for aspiring appraisers to fulfill their experience requirements utilizing technology for practical experience in a virtual environment. The board and division are working to incorporate this new experience pathway, providing more opportunities for aspiring appraisers to train and become licensed in Utah. Division of Securities Utah's securities rules are founded in statute and based largely on national model rules. They are substantively equivalent to those of most other states and consistent with parallel federal requirements. In addition, two Utah rules served as models for subsequent North American Securities Administrators Association (NASAA) model rules. (Whistleblower Rule and Venture Capital Rule). The division adopts new rules only when necessary. Most recent division rules impose no additional requirements but rather expand exemptions from regulations. For instance, Rule R164-4-9 exempts some investment advisors from licensure. This rule was adopted after consultation with stakeholders in the Utah venture capital community and members of the securities section of the bar to design a rule to remove barriers for venture capital activities and for investment advisors to institutional investors. Utah's was one of the first such rules, before the SEC and NASAA model rule. The division is in the process of recrafting the rule, working with industry stakeholders and the securities section to modernize it and incorporate other beneficial exemptions, including those added in the NASAA model rule. The Division of Securities’ comprehensive review revealed that Utah securities rules, and broader regulatory system, are not overly burdensome, containing numerous exemptions from licensing and registration while still protecting investors, and are largely based on federal requirements and nationally accepted model rules. No rules were identified for changes. Removing Barriers Multiple ways exist to ease entry and continuation for licensed professionals. The department has explored these options in recent years, and has done so more deliberately in response to Executive Order 2020-01. Suggested changes in these various categories will be described in subsections below. The changes suggested primarily involve legislative changes and are beyond the department’s ability to address by rule. The department considered changes that could be made to expand opportunity and markets for professionals. One way to do this is to split large scope-of-practice licenses into multiple micro- licenses, allowing narrower qualification for a variety of trades and professions. The department is also evaluating ways to shift licensing and continuing education requirements to competency requirements based on each profession’s suitability for such a shift. A shift away from education- based requirements can likely ease costs and burdens on entry in many cases. Some of these 5 Page
competency-based requirements will require expert analysis to guide statutory changes. Other suggested changes fall into miscellaneous categories and will be described below. While the department recognized the need for change and is therefore including the concepts in this report, the short time frame allotted for the executive order review did not allow for an in-depth analysis of many of these items. Many, if not all, of these changes should undergo a robust review to ensure the proper balance of regulation is found. Create narrower licenses from broad scope-of-practice licenses There are a few obvious places in the Utah Code that could benefit from disintegrating broader categories into narrower licenses. One subject of repeated attention is the Cosmetology and Associated Professions Licensing Act, Utah Code Title 58, Chapter 11a. Another area for ripe for review is the Mental Health Professional Practice Act, Utah Code Title 58, Chapter 60. In recent years the cosmetology statutes and rules have been challenged for regulating too broadly practices that might be better suited for narrower licenses. These narrower licenses could specifically target harm reduction for the public rather than product quality or best practices that may be addressed by typical market forces. This could correspondingly reduce education and training requirements.3 Hair braiding, eyelash application, and eyebrow threading are services that can plausibly be offered with better-targeted training requirements that do not include the full suite of training required for a broadly scoped cosmetology license. The Mental Health Professional Practice Act could also benefit from refined scope of practice rules. The classification of social service worker4 should have its scope of practice reviewed to evaluate whether changes to educational pathways are warranted and whether an associate level license is appropriate. Additionally, remaining license types and scope of practice provisions should be evaluated for necessity and balance. Competency measures to replace educationally-based requirements when possible Over time, the apprenticeship models of the past evolved into largely education-based models of qualifying for licensure. While there is a place for classroom components in training for many professions, often the increase in classroom education has come at the expense of competency- based reviews. Whether in initial qualification for licensure or as continuing education requirements for existing licensees, the public is not always well-served by this shift away from practical competency. Similarly, many competent professionals have their path toward licensure burdened by educational barriers with no practical bearing on their competency to practice. For a professional trained in the US military it is disheartening to finish one’s service to the country through a trade only to find oneself merely at the beginning of a path toward civilian licensure. This example is emblematic of the necessary shift toward competency-based evaluations where appropriate. DOPL has identified areas for review to better incorporate competency-based evaluations in Utah’s professional licensure system. Under current Utah law, DOPL’s director may exercise some discretion, often by rule and with a board’s assent, in allowing a competency-based evaluation to substitute for a time-based one.5 The director may not employ this provision to substitute for an educational component required 3 While there have been legal challenges (Clayton v. Steinagel 2011; Rojas v Steinagel, 2021.), there have also been repeated discussions with legislators and other interested groups concerned limited scope licenses that currently fall within the cosmetology statute. This area is one of perpetual tension between legislators, the industry, and reform- minded groups. 4 Utah Code § 58-60-202 (2) and 58-60-205 (4) 5 Utah Code § 58-1-301(5) 6 Page
by law. The department recommends that this concept be studied to determine if, within certain professions, equivalent competency-based evaluation could be substituted for educational components. Additionally, Utah’s electrical and plumbing trades offer both educational and experience pathways, as well as a method to expedite licensure by demonstrating competency. 6 This additional pathway focuses on an individual’s ability to safely practice rather than a one-size-fits- all set of credentials. In these examples, DOPL and the respective boards were granted rule- making authority to establish the expedited pathways. This language could be considered for other licenses, allowing for expedited licensure pathways where appropriate. DOPL has also identified that some of its own rules might create limits where none are necessary. For example, it will review R156-11a-901, which does not allow on-the-job internships to apply towards credits required for graduation. DOPL has also tasked its boards with reviewing DOPL’s rules with an eye toward identifying professions for which continuing education requirements might be replaced by competency- based ones. These might include work or volunteer options that provide other benefits to the public and participants. Instead of requiring accredited courses, the rules might accommodate employer-required in-service hours aimed at harm reduction. Military training might also fulfill requirements that are now met only through accredited courses. Over the last several legislative sessions, DOPL statutes were modified to allow for increased acceptance of other jurisdictions licenses. Specifically, SB 23, 2020 General Session, allowed for DOPL to issue a Utah license to a licensee from any U.S. state, district, or territory if the scope of that jurisdiction’s license was similar to the Utah scope and the individual had held the license in good standing for at least one year. A similar provision may be appropriate for real estate professionals; however, it is recommended that all applicants be required to take and pass the 24-hour Utah law portion of pre-license education. Miscellaneous issues identified Among the other matters identified for possible change are a number of isolated provisions in statute and rule that might be altered or removed to better enable reasonable professional licensure while continuing to protect the public. Most of these suggestions involve statutes but some have rule components that the divisions will address with the relevant boards. Within DOPL’s pertinent areas, a number of miscellaneous issues have been identified for further action or evaluation through a robust review process. These appear in the following table. Profession Issue Multiple Professions Review high school or equivalent graduation requirements to determine necessity Identify if foreign education or non-approved schools could undergo evaluation for adequacy of coursework Evaluate whether pre-professional or general studies classes can be waived or completed by testing Evaluate specific endorsement restrictions against changes made by 2020 GS Senate Bill 23 6 Utah Code § 58-55-302 7 Page
Consider narrowing the circumstances under which use of specific terminology is prohibited without professional licensure (i.e. prohibiting using the term “engineering” to describe activities to be performed if the individual offering is not licensed (Section 58-22-305(1)); a marketing approach touting a well-engineered multi-tier wedding cake should not be prohibited) Cosmetology Evaluate reduction of apprentice hours professions Evaluate if barbers should be authorized to perform some skin care. Pharmacy Engage in complete rule review after recodification of the statutory Pharmacy Practice Act is complete Design Professions Amend the definition of “principal”7 to reflect changing industry norms Mental Health Consider reduction of post-graduate hours8; Utah requires 4,000 Professions which includes general duties, while most other jurisdictions require 3,000 or fewer if targeted to professional competencies Study supervision requirements to ensure appropriate balance, reporting requirements, and related details Vocational Consider reduction of post-graduate hours; Section 58-78-302; Rehabilitation Utah requires 4,000, while most other jurisdictions require 3,000 Counselors Professional Review experience requirements; Section 58-76-302(4) requires Geologists five years of practice with a bachelor’s degree; other professions require only four Athlete Agents While this is a uniform act, registration requires a number of items that are not used or useful (for example, Subsections 58- 87-202(1)(a) (place of birth); (c), (e)-(f), and (2)-(4) The Division of Real Estate has identified that the Real Estate Licensing and Practices Act contains a few provisions that would benefit from legislative change. First, Section 61-2f- 204(1)(e)(ii) requires that a license be denied if an applicant fails to disclose certain criminal history. While a failure to disclose such an industry-related crime is serious, the DRE has concluded that denial in such circumstances should not be automatic. Instead, discretion should be given to account for the unique circumstances of each case. Likewise sections9 that reference the general term “good moral character” should be modified to remove the ambiguous term and allow the division discretion for unique circumstances that consider the individual applicant’s aggravating and mitigating circumstances. Ongoing Departmental Rule Review In May of this year, Executive Order 2021-12 highlighted that, “the public is best served by clear, cohesive, and concise administrative rules.”10 The department has generally done well at this, both in initial drafting and in statutorily mandated rule reviews under Section 63G-3-305. However, the department’s work on Executive Order 2021-01 has shown this must be an ongoing and 7 Utah Code § 58-3a, 58-22, and 58-76 8 Utah Code § 58-60-205, 58-60-305, 58-60-405 9 Utah Code § 61-2c-203; 61-2e-201; 61-2g-311, 313, and 314 10 https://rules.utah.gov/wp-content/uploads/Utah-Executive-Order-No.-2021-12.pdf 8 Page
regular process that ensures the rules balance necessary protections without creating unnecessary barriers. The department will institute internal processes addressing both executive orders, requiring existing rules and proposed rules be carefully considered for both quality and effectiveness, within statutory constraints. While statute requires agencies to review administrative rules, the department will implement a more robust review process for occupational licensing rules. This process will ensure a more deliberate review than the statute requires and prevent accretion of rules that can hinder thriving professionals and their clients. As the department develops a new process for the mandated five-year reviews, each division with rulemaking authority will assign an Administrative Rules Coordinator. The coordinator will receive training from the Office of Administrative Rules and be responsible to coordinate the rulemaking process within their division and with the department. For each initial rule and rule change, the Administrative Rules Coordinator will ensure that: each rule has been drafted using logical, understandable, and concise language to facilitate compliance and enforcement; interested parties have been given opportunity to participate in the development of the administrative rule pursuant to Subsection 63G-3-301(3); standards reflect consistent and sound public regulatory policies; the rule is consistent with the current edition of the Office of Administrative Rules’ Rule Writing Manual for Utah; and the division evaluates the content of the rule to ensure the rule is necessary and adopts the least restrictive, practical method of implementing the requirements. For each rule’s statutorily mandated five-year review, a more extensive review will be undertaken to identify rules that are no longer necessary or can be amended to reduce barriers. The division and department will consider a variety of items. Among these will be a more explicit review of the statutory authority for the rule, not just to identify if the rule is authorized, but also to ensure the rule’s scope is narrowly tailored to match the authority. Additionally, the department may evaluate trends related to the profession, new technology, market innovations, and changed scopes of practice to assess whether the rules might adapt to reflect changed conditions and better serve Utahns while remaining faithful to the statute and protection of public interests. This thorough review will help identify not only rules that might be altered to better suit changing markets and needs, but matters that can be brought to the legislature for consideration. While the department administers only what the legislature dictates, it can bring its expertise to bear to inform the legislative process when change should be considered. In addition to this heightened review of administrative rules, the legislature should consider a more functional, permanent process for occupational licensing review with a scope broader than the department’s administrative rules. 9 Page
SECTION II Regular, Systematic Review of Professions The current system for periodic review of professional licensing has not functioned well. The legislature established the Occupational and Professional Licensure Review Committee to evaluate proposals for new types of professional licensure, to routinely examine existing professional license categories, and to provide a more thorough review of each licensed occupation at least once every ten years.11. Review criteria within current statute captures many best practices; however, the lack of funding or support for the committee has impeded its function. As such, throughout its existence the committee has rarely performed the required reviews. Nearly all stakeholders the department consulted in its review expressed frustration at the lack of a predictable process for reviewing occupational licensing matters. As stakeholders have adapted to the Occupational and Professional Licensure Review Committee’s limitations, reforms have occurred intermittently as industry or other public interest groups muster the support for measures designed to tackle specific concerns. As noted in the discussion of departmental rules above, periodic reviews of regulations can help prevent a stifling accretion of restrictions that might serve (or once have served) some useful purpose in isolation but combine to create unnecessary barriers to enter the profession or negatively affect the people and professions they are intended to protect. A new system for broader review should be strongly considered. The department proposes one here. Regular, ongoing, impartial review by the executive branch One of the key insights from stakeholders the department consulted was that an executive branch review and advice process could be more predictable and insulated from political influences than the existing Occupational and Professional Licensure Review Committee process. Such a process would continue to allow the legislature to be the key decision maker on occupational licensing issues while benefiting from the regularity and expertise of the executive branch. Wherever the executive function is located, it would be guided in its work by legislative priorities and report its work to the legislature for ultimate action. If it suggested actions that were within the then-current authority of other agencies to address, those agencies would be required to independently adopt those recommendations, or not, based on their own authority. This structure matches feedback the department received. Various groups opined that an executive branch review could provide greater impartiality and distance from legislative decisions that might result in better information for legislative decision makers. Of course, such a system must be trusted by all stakeholders, including the Governor, legislature, trade associations, public interest groups, affected agencies, and the public. Professional licensure reform groups affirm these conclusions, with their suggested best practices including robust, ongoing professional review with expert analysis. Through research and discussion with stakeholders, the department has identified a number of parameters the legislature might consider for such an executive review process. These address the organizational location of the process, its necessary funding and funding mechanism, and professions that might be included. The department recommends the location of the proposed ongoing review be the Department of Commerce. Commerce has the benefit of deep, ongoing expertise about not only the professions it regulates, but with broader reform efforts, market trends, and relevant data. Concerns about potential conflicts with locating the function would be mitigated with dedicated review staff, located 11 Utah Code Section 36-23-101, et seq. 10 P a g e
within Commerce but not within the licensing divisions, that are removed from the day-to-day functioning of license approvals and discipline. An ongoing effort that enables review of each licensed profession every ten years, while allowing for legislative prioritization and one-off reviews to address immediate legislative proposals, would require four full-time equivalent positions if located in Commerce. This would allow maintenance of ongoing expertise sufficient to handle both regular reviews and other proposals that are currently within the Occupational and Professional Licensure Review Committee’s purview. Funding could be achieved with an additional appropriation from existing fees collected in the Commerce Service Fund. The department’s fees regularly bring in more revenue than appropriated to the department. Increasing the department’s appropriation from its collected fees to cover the cost of this program would allow full program funding without increasing fees for licensees or reducing funds available for any other licensing agency’s ongoing funding. This executive function would include all licenses issued by executive branch agencies within the State of Utah. Ongoing legislative input to executive branch Creating a new executive review process for occupational licensing is likely to increase the legislature’s input in occupational licensing matters. It will do so by providing more frequent and realistic opportunities for considered legislative guidance instead of intermittent consideration of proposals brought by others. Intermittent proposals by other interests would, of course, not be prohibited. The existing Occupational and Professional Licensure Review Committee has not met frequently and has not undertaken many of the statutory functions assigned to it. The department’s review suggests this is largely the function of constraints on legislative service and resources. Legislators and their staff are busy with a variety of meetings and functions. Legislators and their staff cannot engage in full-time consideration of each area of state government. Dedicated professionals cannot always dedicate themselves to every area of their profession each year. Further, limited budget resources cannot always be employed by the legislature to procure expert analysis of areas beyond its native expertise. Legislative delegation to an executive entity to engage in deeper analysis is more likely to allow consistent, meaningful legislative input. The work of an executive agency reviewing occupational licensing provisions would be informed in the first instance by a set of codified legislative principles and directions, as well as incorporate executive input. Additionally, the legislature could annually prioritize reviews for consideration and request one-off, quick responses to legislative proposals. Reviews could include broad evaluation of professions, universal analysis of education provisions, market evaluations, and other as- needed matters. Annually prioritized and one-off reviews would be additional to the scheduled, ongoing reviews of each profession every ten years. The executive agency charged with these reviews would perform its work on an ongoing basis as informed by legislative priorities. Individually or collectively, the results of these reviews would be reported to the legislature for consideration for further action, and include stakeholder input specific to the completed analysis. Thus, the legislature would begin its legislative work by prioritizing issues for consideration based on informed executive input and conclude its legislative work by implementing, or not, executive recommendations, that include stakeholder input, based on earlier legislative input. Under this updated process, more frequent review of all professions would occur systematically, with an emphasis on nimble legislative guidance. This would promote responsive, relevant, and reliable regulation that would reduce frustration and pain points for licensees and other 11 P a g e
stakeholders and facilitate trusted and ongoing licensing reform as part of Utah’s legislative and regulatory DNA. Licenses to consider for evaluation utilizing the proposed process The department’s current review of existing licenses revealed some license classifications that should be evaluated through the proposed process. In many cases these are classifications practicing in a narrow set of circumstances that are related to other existing licenses. Others seem to have limited utility or other circumstances warranting elimination. Profession Explanation Environmental Health License is required for only employees of government agencies Scientist that can monitor competence and performance 58-20b There are numerous exemptions A national certification is the basis for licensure Medication Aide Expands the CNA designation, allowing medication tasks. This Certified may be more effectively accomplished through an exemption for 58-31b a properly trained CNA Currently requires 2,000 hours experience, 60 hours education, 40 hours on-the-job training, and an exam Federal legislation requires health care facilities to perform background checks, which will reveal many of the issues DOPL’s review was designed to address Controlled Substance Review possible reduction from license to registration Precursors Current requirement is for reporting, with no qualifications to 58-37c obtain the license Evaluate FDA, DEA, and other federal requirements to ensure Utah is not duplicating reporting requirements Therapeutic One of three related classifications Recreational This classification is limited to on-site supervised activities Technician Duties are limited and generally overseen by other licensees 58-40 The lack of independent scope suggests licensure may be unnecessary to protect the public 12 P a g e
Certified Dietician Current certification simply verifies national certification 58-49 No unlawful conduct or other scope provisions exist in Utah law Countervailing considerations may exist if continued licensure is needed for medical insurance reimbursements (current CMS guidance do not require this, so state certification is likely unnecessary to qualify) Building Inspector Building inspectors are employees of or contractors for regulatory 58-56 agencies that can monitor competence and performance A national certification is the basis for licensure Deception Detection Duplicated requirements as individuals who are licensed are Examiners, Interns generally employed by law enforcement agencies, and are POST and Examination certified Administrators Currently only 32 licensees (20 Examiners, 1 Intern, 11 Examination Administrators State Certified Court Current certification simply verifies national certification Reporters Judicial branch oversees its employees’ certification 58-74 Certified Medical Current certification simply verifies national certification Interpreters No additional harm reduction measures within Utah law 58-80a Statute offers competitive edge by allowing Department of Health and the Department of Human Services to give preference when awarding contracts to state-certified providers (58-80a-601) Online Prescribing, Evaluate need for all three classifications. There are currently 2 Dispensing, and online facilitators, 2 online contract pharmacies, and 3 online Facilitation prescribers. 58-83 If need is identified, consider restructuring as a certification or endorsement to expand the scope of another existing license State Certified Music Current certification simply verifies national certification Therapist The only conduct provisions are discipline by the national 58-84 organization The state certification appears to serve merely as title protection State Certified Current certification simply verifies national certification Commercial Interior Scope is very limited; design is covered only when a permit is Designers obtained independent of an architect in certain circumstances; 58-86 other interior design is exempt 13 P a g e
SECTION III Required Actions The Governor and legislature should consider the following actions. Modification to board and division duties An integral part of any program, plan, or partnership is clear expectations. Over the last decade, the legislature has demonstrated a desire for the department to be mindful of licensing reform. Executive Order 2021-01, issued just hours after inauguration, emphasized the same message. It is requested that general authority be added to the duties of each division and the boards they oversee to include language that focuses these expectations. For example, the Division of Occupational and Professional Licensing Act could be modified as follows: In 58-1-202, modify the first board duty, subsection (1)(a), to “(a) recommending to the director appropriate rules and statutory changes, including removal of barriers that are no longer necessary or effective in protecting the public and enhancing commerce.” In 58-1-301, amend subsection (1)(b)(i) to “(i) contain documentation of the particular qualifications required of the applicant to comply with these statutes or rules promulgated under these statutes”; In 58-1-401, provide language to address creating rules for aggravating and mitigating circumstances that allow the division to provide individual consideration to applicants. Statutory changes The department’s primary focus was to evaluate the administrative rules within its purview to identify those that are no longer necessary or could be amended. In doing so, however, many items were also identified within statute that create barriers, could be more closely tailored to address harm, or provide clarity. Previously, in Section I: Reducing Barriers, concepts were presented that would require additional review prior to concrete statutory change proposals. In addition to those suggested review items, many areas of statute lend themselves to immediate solutions. Below is a list of suggested modifications to statute addressing those needs. Profession Reason Title 58, Multiple: Overbroad good character provisions should be Funeral Services 58-9-302 removed in favor of the standards found in 58-1-401 Health Facility Administrator 58-15-4(1) Veterinary 58-28-304 Nurse Midwife 58-44a-302 Burglar Alarm 58-55- 302(3)(k)(vii) and (l)(iii) Security 58-63-302 Deception Detection 58-64- 302 Online Prescribing, Dispensing, and Facilitation 58-83-302 Title 58, Multiple: Individual section endorsement provisions are out of Podiatry 58-5a-305 line with 58-1-302, and overly restrictive considering Health Facility Administrator the profession 58-15-4(6) Optometry 58-16a-302 14 P a g e
Veterinary 58-28-304 Health Facility Administrators: General recodification to match division’s standard 58-15 outline Environmental Health Scientists Rather than overbroad “Food Quality,” the term 58-20b-102(4)(ii): should be changed to the more measured, harm- focused “Food Safety” Engineers Remove the word “direct” from supervision 58-22-102(10) requirements, and reference the definition of supervision in Section 58-22-102(16) Speech Language Pathologist and The board has requested that an exemption from Audiologists licensure be created for the practice of Newborn 58-41 Hearing Screenings that is similar to the exemption for elementary audiometry found in 58-41-4(1)(i). Rather than being employed by a medical doctor, however, the exempt individual would be the trained representative of the program responsible for the newborn hearing screening Security Replace corporate officers with “responsible 58-302(1)(c)(ii) management personnel” Chiropractic Exams are incorrectly identified/named. Subsection 58-73-302(1)(e) (i)(B) is clarified in rule to be either Part III or the SPEC; Subsection (i)(C) should be “Physiotherapy” Consider whether a rule grant of “or other equivalent” could be added (similar to (iii)) so DOPL can address future exam updates nimbly Utah Vital Records Include Certified Nurse Midwives in the definition of 26-2-2(11) “health care professionals” Residential Mortgage Remove overbroad good character provisions 61-2c Remove language authorizing the division to collect “reasonable expenses incurred by the division in processing the application” in favor of only the division’s set application fees Allow for a mortgage licensee to have a license revocation vacated after a hearing before the mortgage commission Appraisal Management Company Remove overbroad good character provisions 61-2e Remove requirement that an individual in violation of the chapter pay the costs incurred by the division Real Estate Remove automatic revocation for failure to disclose 61-2f a criminal record in favor of allowing discretion based on aggravating and mitigating circumstances Remove fee for changing an address, name, etc. Remove requirement that an individual in violation of the chapter pay the costs incurred by the division Clarify or provide rule making authority surrounding the difference between commission sharing and the legality of inducement and closing gifts Real Estate Appraiser Remove overbroad good character provisions 61-2g 15 P a g e
Considerations for Future Licensing Reform The review effort the department undertook in response to Executive Order 2021-01 was robust. While many actions have occurred and will soon occur to implement findings, other areas were identified that are susceptible for future study. Thorough review of these items could not occur during the time set for completion of this review. Below are items the department, the legislature, or a future executive reviewer might profitably consider for future reform. A few of them have general application while others are specific to certain professions. General Study effectiveness of the required Suicide Prevention Continuing Education requirement that was added to multiple professions to determine if adjustments should be made. Evaluate existing fee waivers authorized by statute and whether additional criteria should be added. Section 58-1-301.3 currently allows for fee waivers of DOPL applicants for active duty military and those that receive certain state benefits. Evaluate if an individual who receives a temporary license under Section 58-1-303 should receive two opportunities to take the exam, rather than only one, or if this should be left to individual professions to determine risk. Profession/section specific Pharmacy: Complete an extensive rule review after the current recodification is complete. Additionally, evaluate the following statutory provisions: o 58-17b-305 and 305.1(2) Review necessity of specifically excluding Pharmacists from downgrading to Pharmacy Technicians. o 58-17b-302 Evaluate the need for each physical location of pharmacy to hold a separate license. Additionally, evaluate the need for new licensure for change of ownership, name, etc. Nurses: Evaluate removal of the outright, lifetime ban on violent felonies and possibly allow the division to apply the standards outlined in 58-31-302(9) to all charges (58-31b- 302(8)). Controlled Substances: In conjunction with recodification of 58-17b, evaluate standards in statute and rule (esp. those found in the 600 series of R156-37) to ensure least restrictive/national standards are met (Chapters 37 and 37f). Nurse Midwives: Evaluate current Certified Nurse Midwife’s controlled substance authority to determine if it should mirror their APRN peers, whose scope includes schedule II and III (58-44a-102 (9)(c) and 58-31b-803) Elevator Mechanics: Requirement that training be within the last ten years does not appear to be within any rule grant of statute (R156-55e-302a(1)(c)). Evaluate need and intent. Landscape Architects: Evaluate need for Landscape Architect Board (Section 58-53-201), which has not met since 2019. Security Personnel: Study the possibility of reducing continuing education requirements by requiring post-licensure in-service within the first 3 or 6 months that specifically address core competencies needed (Chapter 63). Real Estate: Evaluate the reinstatement criteria found in 61-2f-204(2) to ensure the criteria are properly balanced and appropriately targeted to reduce the potential harm associated with re-entry into the profession. 16 P a g e
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